Lichenoid Photosensitivity: An Unusual Reaction to Doxycycline and an Unusual Response

A 16-year-old adolescent girl was referred to the dermatology department for a possible lye burn. The patient's acne vulgaris was being treated with doxycycline for the last 7 months. During the spring months, she reported pruritic dermatitis comprised of pink polygonal papules with some confluence into plaques that developed on the dorsal aspect of the hands and forearms in a sun-exposed pattern. Given the physical findings, a presumptive diagnosis of a photosensitivity reaction to doxycycline was made.